一、痘当起胀三日之后，根窠红润，贯脓充满，如黄蜡色，二便如常，饮食不减，吉候也，
不必下药；如红紫黑色，外剥声哑者，死。
一、痘当贯脓之时，纯是清水，皮白如薄，与水泡相似，三四日遍身抓破而死。
一、痘当贯脓之时，痘中干枯，全无血水，此名空疮痘，决死。
一、痘当贯脓之时，吐痢不止，或二便下血，乳食不化，痘烂无脓者，决死。
一、痘当贯脓之时，二便不通，目闭声哑，腹中胀满，肌肉黑者，死。
凡痘十日，十一二日，痘渐收靥，自上而下为顺，自下而上为逆，其遍身皆靥，虽数颗不靥，尚能杀人，
犹蛇蜕皮，虽一节被伤，不能退者，是亦死也。
夫出痘十一二日，从口唇头面逐渐收靥至足者，不须服药，若有他证，然后论治。
凡痘当靥不靥，泄泻寒战，切牙抓破，此虚寒者，服异功散；
触秽冒寒，黑陷不靥，煎异功散调下无价散。外痒者，外用去秽散熏之。
凡过服热药，以致热毒猖狂，气血弥盛，痘烂不靥者，内服小柴胡汤、猪尾膏解之，外用败草散敷之。
凡痘在前发越已透，贯脓已满，兹解毒已清，至收靥时，或因
触冒，致陷伏，斑烂痒塌不靥者，但服异功散自愈，疮虽不起，不必忧也。
凡痘皆收靥，惟数颗臭烂，深坎不收口者，用硝胆膏涂之。
凡痘不收靥，气急上痰，声哑目闭无神者，死；靥后瘢红者，吉。白者、血色者，毒瓦斯归内也，恐生余证。
凡痘收靥后，气血大虚，肌肉柔嫩，不耐风寒，慎戒触冒风寒，
乘凉不谨，轻则余毒内攻，重则中风瘫痪，危矣，戒之戒之。
凡痘既收靥，欲落不落而燥痒者，或疮痂虽落，其色黯，或凸
或凹，或疮愈痂未落，用白沙蜜不拘多少，涂于疮上，其痂易落，亦不令瘢痕紫黑，又不腥秽，甚妙。
凡痘疮已靥未愈之间，五脏未定，肌肉尚虚，血气未得平复，忽被风寒搏于肤腠之间，则津液涩滞，
故成疳蚀疮，宜雄黄散、绵茧等药治之，久而不愈者，溃骨伤筋，以害人也。
小儿痘自出至收靥要十二日可保平安，首尾不可与水吃，少与滚熟水则可，若误与之，疮靥之后，其痂
迟落，或身上痈肿，若针之则成疳蚀疮，脓水不绝，甚则面黄唇白，以致难愈者何也？盖脾胃属土，外主
身之肌肉，只缘饮水过多，湿损脾胃，搏于肌肉，其脾胃肌肉虚，则津流衰少，而荣卫滞涩，气血不能
周流，凝结不散，故疮痂迟落而生痈肿也。
黄帝曰∶饮有阴阳何也？好饮冷者，冰雪不知冷；好饮热者，沸汤不知热。岐伯对曰∶阳盛阴虚，饮
冷不知寒；阴盛阳虚，饮汤不知热。治之何如？故阳盛则补阴虚，木香散加丁香、肉桂治之；阴盛则补阳虚，
异功散加木香、当归，每一两药共加一钱。异功散能除风寒湿痹，调和阴阳，滋养血气，使痘疮易出，易靥，
不致痒塌；木香散性温平，能和表里，通行津液，清上实下，扶阴助阳之药也，善治小儿腹胀泻渴，其
效如神，不能尽述。大抵天地万物，遇春而生发，至夏而长成，乃阳气熏蒸，故得生长者也。今疮疹之
病，脏腑调和，则血气充实，自然易出易靥，盖因外常和暖，内无冷气之所由也。
一、痘疮在起胀三天之后，如果痘根周围红润，脓液充满，颜色像黄蜡一样，大小便正常，饮食没有减少，这是吉利的征象，不需要服用泻下药；如果痘色呈现红紫或黑色，且伴有声音嘶哑者，预后不良，主死。
一、痘疮在化脓的时候，如果痘内全是清水，皮薄白如纸，与水泡相似，三四天后全身抓破而死。
一、痘疮在化脓的时候，痘体干枯，完全没有血水，这叫做“空疮痘”，判定为死证。
一、痘疮在化脓的时候，呕吐腹泻不止，或者大小便下血，乳食不消化，痘烂没有脓液的，判定为死证。
一、痘疮在化脓的时候，大小便不通，眼睛闭合，声音嘶哑，腹部胀满，肌肉发黑的，主死。
凡是痘疮到了第十天、第十一或十二天，痘疮逐渐结痂（收靥），从上往下发展为顺证，从下往上发展则为逆证。即使全身都结痂了，如果有几颗不结痂，也足以导致死亡，就像蛇蜕皮一样，虽然一节受损不能褪去，也是死路一条。
出痘后的第十一、十二天，痘疮从口唇头面逐渐结痂直到脚部，这是顺证，不需要服药；如果有其他症状，然后再进行论治。
凡是痘疮该结痂时不结痂，伴有泄泻、寒战、咬牙、抓破皮肤，这是虚寒证，服用异功散；
如果是触犯了秽浊之气或感受寒气，导致痘色黑陷不结痂，煎服异功散并调服无价散。如果外感瘙痒，外用去秽散熏蒸治疗。
凡是过度服用热药，导致热毒猖獗，气血壅盛，痘疮溃烂不结痂的，内服小柴胡汤和猪尾膏来解毒，外用败草散敷贴。
凡是痘疮在前面已经透发透彻，化脓已满，此时解毒已清，到了结痂阶段，却因为触犯外邪，导致痘疮陷入潜伏，斑烂瘙痒塌陷不结痂的，只要服用异功散即可自愈，疮口虽然不起，也不必担忧。
凡是痘疮全部结痂，只有几颗臭烂，深陷无法收口的，用硝胆膏涂抹。
凡是痘疮不结痂，气急上痰，声音嘶哑，眼睛闭合无神气的，主死；结痂后瘢痕发红是吉兆。瘢痕发白或呈血色，说明毒瓦斯回归体内，恐怕会产生余留病症。
凡是痘疮结痂后，气血大虚，肌肉柔嫩，不耐受风寒，必须谨慎戒除触犯风寒，乘凉如果不谨慎，轻则余毒内攻，重则中风瘫痪，非常危险，务必戒慎。
凡是痘疮既已结痂，想要脱落却因干燥瘙痒而难落，或者疮痂虽然脱落，但颜色暗滞，或者凸起或凹陷，或者疮愈痂未落，可以用白沙蜜不拘多少，涂抹在疮上，这样痂皮容易脱落，也不会留下紫黑色的瘢痕，且不腥臭，效果很好。
凡是痘疮已结痂但未痊愈之间，五脏功能尚未稳定，肌肉尚虚弱，血气未能平复，忽然被风寒侵袭于皮肤腠理之间，则津液涩滞，从而形成疳蚀疮，适宜用雄黄散、绵茧等药物治疗，如果久治不愈，会溃骨伤筋，危害生命。
小儿痘疮从发出到结痂需要十二天才能保平安，从头到尾不可喂生水，少量给予煮沸过的熟水则可以，如果误喂生水，在疮痂结后，会导致痂皮迟落，或者身上出现痈肿，如果用针挑破则变成疳蚀疮，脓水不绝，甚至面色发黄嘴唇发白，以致难以治愈，这是什么原因呢？因为脾胃属土，外部主管身体的肌肉，只因为饮水过多，湿气损伤脾胃，湿气搏结于肌肉，使得脾胃和肌肉虚弱，那么津液流动衰少，营卫之气滞涩，气血不能周流全身，凝结不散，所以疮痂迟落而生痈肿。
黄帝说：饮水有阴阳之分是怎么回事？喜欢喝冷水的人，连冰雪都不知道冷；喜欢喝热水的人，连沸水都不知道热。岐伯回答说：阳气盛阴虚的人，喝冷水不知道寒；阴气盛阳虚的人，喝热水不知道热。怎么治疗呢？所以阳气盛则补阴虚，用木香散加丁香、肉桂治疗；阴气盛则补阳虚，用异功散加木香、当归，每两药共加一钱。异功散能祛除风寒湿痹，调和阴阳，滋养血气，使痘疮容易发出，容易结痂，不至于瘙痒塌陷；木香散性温平，能调和表里，通行津液，清上实下，是扶助阴助阳的药物，善于治疗小儿腹胀、腹泻、口渴，其效如神，不能详尽叙述。大抵天地万物，遇到春天就生发，到了夏天就长成，这是因为阳气熏蒸，所以得以生长。如今疮疹这类疾病，脏腑调和，则血气充实，自然容易发出容易结痂，大概是因为外部常保持和暖，内部没有冷气的原因。
1. After the pustules have been swelling for three days, if the base of each pustule is ruddy and red, filled with pus, and yellowish like beeswax, with normal urination and defecation, and no reduction in appetite, this is an auspicious sign; no purgative medicine is needed. If the color is red, purple, or black, accompanied by hoarseness, death ensues.
2. When the pustules are maturing into pus, if they contain only clear fluid, with thin white skin resembling a water blister, and the patient scratches them all over the body until death occurs within three to four days.
3. When the pustules are maturing into pus, if the pustules are dry and shriveled with no blood or fluid inside, this is called "Empty Pustule Disease" (Kong Chuang Dou), which indicates a fatal prognosis.
4. When the pustules are maturing into pus, if there is incessant vomiting and diarrhea, or bleeding from both urine and stool, indigestion of milk and food, and the pustules are ulcerated without pus, this indicates a fatal prognosis.
5. When the pustules are maturing into pus, if there is obstruction of urination and defecation, closed eyes, hoarseness, abdominal distension, and blackening of the muscles, death ensues.
Generally, on the tenth day, or the eleventh and twelfth days after onset, when the pustules begin to scab over (Shou Ye), progression from top to bottom is considered favorable (Shun), while progression from bottom to top is unfavorable (Ni). Even if the entire body has scabbed over, if a few spots fail to scab, it can still be fatal, similar to a snake shedding its skin: if one segment fails to shed due to injury, the snake dies.
On the eleventh or twelfth day, if the pustules gradually scab over starting from the mouth, lips, head, and face down to the feet, this is favorable, and medication is not required. If other symptoms appear, treatment should then be discussed.
If the pustules fail to scab over when they should, accompanied by diarrhea, chills, teeth grinding, and scratching until broken, this is a deficiency-cold syndrome; administer Yi Gong San (Isolated Efficacy Powder).
If triggered by foul pathogens or cold invasion, resulting in black sunken pustules that fail to scab, decoct Yi Gong San (Isolated Efficacy Powder) and mix with Wu Jia San (Priceless Powder) for administration. For external itching, fumigate with Qu Hui San (Remove Filth Powder) externally.
If excessive use of hot medicines leads to rampant heat-toxin and hyperactive Qi and Blood, causing pustules to ulcerate and fail to scab, internally administer Xiao Chai Hu Tang (Minor Bupleurum Decoction) and Zhu Wei Gao (Pig Tail Paste) to resolve the toxin, and apply Bai Cao San (Defeat Grass Powder) externally.
If the pustules were previously fully erupted and matured with sufficient pus, and the detoxification was already cleared, but during the scabbing stage, external pathogenic factors cause the lesions to sink and stagnate, becoming ulcerated, itchy, collapsed, and failing to scab, simply administering Yi Gong San (Isolated Efficacy Powder) will lead to self-healing. Although the sores may not rise, there is no need to worry.
If all pustules have scabbed over except for a few that are foul-smelling and ulcerated, deeply depressed, and failing to close, apply Xiao Dan Gao (Nitre Gall Ointment).
If the pustules fail to scab over, accompanied by rapid breathing, phlegm rising, hoarseness, closed eyes, and lack of spirit, death ensues. Red scars after scabbing are auspicious. White or bloody-colored scars indicate that toxins have returned inward, raising concern for residual complications.
After the pustules have scabbed over, Qi and Blood are greatly deficient, and the muscles are tender and unable to withstand wind and cold. One must strictly avoid exposure to wind and cold. Negligence in cooling off can lead to mild cases of internal attack by residual toxins, or severe cases of wind-stroke paralysis, which is critical. Beware, beware.
If the scabs are dry and itchy, reluctant to fall off, or if the scabs have fallen but the color is dark, or if the surface is convex or concave, or if the sore has healed but the scab remains, apply an appropriate amount of Bai Sha Mi (White Sand Honey) to the sores. This facilitates easy removal of scabs, prevents purple-black scarring, avoids odor, and is highly effective.
During the period between scabbing and healing, when the Five Zang organs are unstable, muscles are weak, and Qi and Blood have not yet stabilized, sudden exposure to wind and cold at the skin and interstices causes stagnation of body fluids, leading to Gan Shi Chuang (Gan Eroding Sores). Treat with Xiong Huang San (Realgar Powder) and Mian Jian (Cocoon) etc. If prolonged and unhealed, it may erode bone and damage tendons, harming the person.
For children, smallpox/rash requires twelve days from eruption to scabbing to ensure safety. Raw water should not be given from start to finish; boiled warm water is acceptable. If raw water is mistakenly given, after scabbing, the scabs may fall late, or abscesses may form on the body. If punctured, these become Gan Shi Chuang (Gan Eroding Sores) with continuous pus discharge, potentially leading to yellow face and white lips, making cure difficult. Why? The Spleen and Stomach belong to Earth and govern the muscles externally. Excessive drinking damages the Spleen and Stomach with dampness, which binds to the muscles. When Spleen/Stomach and muscles are weak, fluid flow decreases, Ying and Wei Qi become stagnant, and Qi and Blood cannot circulate freely, condensing and not dispersing. Thus, scabs fall late and abscesses form.
The Yellow Emperor asked: What is the Yin-Yang distinction in drinking? Those who prefer cold drinks do not feel the cold even of ice and snow; those who prefer hot drinks do not feel the heat even of boiling water. Qibo replied: In cases of Yang excess and Yin deficiency, drinking cold does not feel cold; in cases of Yin excess and Yang deficiency, drinking hot does not feel hot. How to treat? Therefore, for Yang excess, tonify Yin deficiency using Mu Xiang San (Aucklandia Powder) added with Ding Xiang (Clove) and Rou Gui (Cinnamon Bark); for Yin excess, tonify Yang deficiency using Yi Gong San (Isolated Efficacy Powder) added with Mu Xiang (Aucklandia) and Dang Gui (Angelica Sinensis), adding one qian per liang of herbs. Yi Gong San (Isolated Efficacy Powder) dispels wind-cold-damp bi, harmonizes Yin and Yang, nourishes Qi and Blood, facilitating eruption and scabbing of rashes, preventing itching and collapse. Mu Xiang San (Aucklandia Powder) is warm and neutral, harmonizing interior and exterior, promoting fluid circulation, clearing the upper and solidifying the lower, assisting Yin and Yang. It effectively treats pediatric abdominal distension, diarrhea, and thirst, with miraculous efficacy, too numerous to detail. Generally, all things in heaven and earth sprout in spring and grow in summer due to the steaming of Yang Qi. In rash diseases, if the Zang-Fu organs are harmonious, Qi and Blood are substantial, leading to easy eruption and scabbing, primarily because the exterior is kept warm and the interior lacks cold qi.